Re: Delayed Treatments for Prostate Cancer


"george conklin" <george@xxxxxxx> wrote in message
news:jFBGg.116$bM.4@xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx

The issue is to what degree surgery, by any technique, is going to do
much for a patient. You point to a 3% difference over 10 years as a major
victory, even while the big studies, much delayed, are just getting
started. One has been going 10 years with no results announced yet.

NEJM V347(11) from Sept 2002:
studied 700 men with prostate cancer. Median f/u of 6 years (not adequate
for prostate cancer studies) showed an improved disease specific survival -
a decrease from 8.9% to 4.6% which is a 48% reduction.

NEJM V352(19) from May 2005
Same group with longer followup, now out to 8 years (still not adequate).
Showed that "radical prostatectomy reduces disease specific mortality,
overall mortality, and the risks of metastasis and local progresssion".
Overall survival was improved by 22%. Not 3%...... but 22%. That was
statistically and is clinically significant.

That is the real world data. That is LEVEL 1 evidence - these patients who
were diagnosed with cancer were RANDOMLY ASSIGNED to either watchful waiting
or to surgery. These were not "self selected" patients as you have
incorrectly argued. The numbers are not small. It was a well designed
study with a very clear endpoint showing a significant improvement in
survival in the treatment group.

Yes, that is a major victory.

No go play elsewhere cause you're in over head.


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